REPETITIVE STRESS CONDITIONS: HAND AND UPPER EXTREMITY

By: Adrienne Driggers Riveros, MOTR/L

Every year, many people suffer from repetitive stress conditions and are unaware of the simple strategies that may help manage or alleviate their symptoms. This article will describe some of the most common repetitive stress conditions, explain the basic anatomy and give pointers on how to effectively manage these conditions.

What is Tennis Elbow?

Tennis elbow refers to a condition near the outside of the elbow where the symptoms include pain,

The condition typically occurs when the forearm extensor muscles are used repetitively. Over time, this can cause small tears to develop in the tendon that attaches these muscles to the bone at the outside of the elbow. Some common activities with repetitive wrist motion that can cause tennis elbow include:

• Playing tennis

• Prolonged use of a screwdriver, hammer, pliers, wire strippers or other tools

• Painting

The most common treatment option is to stop or decrease the repetitive stress as much as possible. Icing get better or worsens, a visit to the physician may be necessary. They may choose to administer an injection or may send you to therapy. Among other things, therapy may include a wrist support splint to limit the strain on the forearm muscles, education on a counterforce band or Tendon Trak (takes the load off of the irritated tissue), stretches andrange-of-motion exercises and/or Iontophoresis (medicated patches).

It is very important to note that, even after a person is feeling better, it is still necessary to ice and stretch for a length of time to prevent the condition from returning.

TIP: If you are a tennis player, make sure you have the right size racquet. A racquet that is too big can put unnecessary strain on your extensor muscles. Adjust your string tension to a lower level, as strings that are too tight can increase the amount of strain in the arm.

is CTS?

Carpal tunnel syndrome is the most common nerve compression of the upper extremity. It is typically characterized by pain, tingling and

Among other things, it can be caused by:

• Repetitive stress (i.e. assembly line work)

• Swelling in the area of the carpal tunnel (i.e. pregnancy)

• Ganglion cyst

• Direct trauma to the carpal canal i.e. falling on an outstretched wrist; hitting wrenches with the heel of the hand)

• Prolonged hyperextended or wrist (i.e. sleeping with wrist(s) in awkward positions)

The carpal tunnel refers to a canal located at the base of the hand. It is bound on three sides by the carpal bones. The transverse carpal ligament covers the canal and can be thought of as the “roof” of the carpal tunnel. thumb pass through the carpal tunnel, in addition to the median nerve. The median nerve gives sensation to the thumb, index, middle and half of the cyst, an injury to this area, etc., may cause pressure on the nerve. If this occurs, some common symptoms are numbness, tingling, pain and/ or muscle weakness. You may also as this motor action is controlled by the median nerve.

Common treatments of CTS include decreasing repetitive stress, splinting with a wrist support at night, rangeof-motion/nerve gliding exercises, (NSAIDS), a cortisone injection administered by a physician and surgery for severe cases.

TIP: Many people in manual labor jobs tend to use the heel of their hand like a hammer. Instead of hitting wrenches, handles, boards, etc. with your hand, try to use a different tool in place of your hand.

From an acute onset of tennis elbow to a gradual onset Carpal Tunnel Syndrome, the functional impact of repetitive stress conditions can be debilitating. Please note that the information presented in this article is only a basic guideline. If you are having symptoms that do not subside with common treatments or the symptoms get worse, it may be necessary to consult your physician. Among other things, your physician your needs.

Adrienne Riveros is a licensed Occupational Therapist. She earned her Masters Degree in Occupational Therapy from the University of Florida. Although Adrienne went into hand therapy after graduation, she originally went to Occupational Therapy school in order to work with children with autism. She is an active member of The American Occupational Therapy Association and enjoys writing, painting, photography and horseback riding.